Torn Cartilage

Cartilage tears such as the meniscus are one of the most common knee problems, because it is subject to many stresses and has limited blood supply. It is therefore unable to undergo a normal healing process. Tears not associated with an ACL injury generally do not heal as well as those incurred during such an injury. With age, the meniscus also begins to deteriorate and can develop small tears even without injury. When a sudden impact, excessive wear, and/or the degenerative effects of aging damage this cartilage, it begins to move uncomfortably inside the knee joint – causing the same type of discomfort as a stone in a shoe. Often times the torn meniscus can become caught between the bones of the joint and cause pain and swelling, making movement impossible.

At the Sanders Clinic, initial recommendations are not surgical provided the knee is not locked and able to come to full extension. A significant number of patients are able to avoid arthroscopic surgery with a proper Reconditioning Program. Anti-inflammatory medications such as Celebrex, or Advil are started. Nutritional supplements for articular support are added to the program and an exercise plan is instituted utilizing a Step Box for both legs. This simple device is used for the performance of closed chain knee extension exercises on both legs, beginning with four sets of 25 reps of two-inch excursions each day then increasing until 50 reps can be performed. The same routine is then continued with a four-inch excursion. After the same goal is reached, the excursion is increased to six, then eight inches. Patients must do at least four sets per day on each leg. The patient may start to work in the stationary bike and/or the Stairmaster, as well as continue with the Step Box at increasingly longer excursions through the end of the second week. Additionally in the second week, programs of jogging, swimming, and specific sport-related activities are begun, if a specific sport is not already in progress. Athletes may continue to participate in their desired sport.

In those patients who do not have significant arthritis, yet are not responsive to these measures, torn edges of the cartilage can be arthroscopically removed and the cartilage reshaped within the knee. This minimally invasive procedure allows immediate movement of the knee typically will allow persons to leave the hospital under their own power without the need for crutches.  Recovery is rapid, and provided that arthritis is not present, excellent results can be expected.

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